Medicare Coverage for Mental Health Services

As mental health awareness continues to grow, Medicare recipients are seeking clarity on how Medicare supports mental health services.

Medicare is divided into different parts, each covering specific types of services:

• Medicare Part A Is hospital insurance that may help cover inpatient stays, skilled nursing facility care and home health care.

• Medicare Part B is medical insurance that may help cover outpatient care, doctor visits, preventive services and mental health services.

• Medicare Part C is also known as Medicare Advantage, and these private plans combine Part A and Part B coverage and often include additional benefits.

• Medicare Part D is prescription drug coverage provided through private insurers.

For mental health services, the most relevant parts are Part B and Part C, with Part D playing a role in medication management.

Mental Health Coverage Under Medicare Part B

Medicare Part B may help cover a range of mental health services, including the following:

• Outpatient therapy, including individual and group sessions, provided by licensed professionals, such as psychologists, clinical social workers and licensed marriage and family therapists

• Initial psychiatric evaluations by psychiatrists or other mental health professionals

• Counseling services for conditions like depression, anxiety and other mental health issues

• Diagnostic tests performed by a mental health provider to determine a diagnosis or treatment plan

Mental Health Coverage Under Medicare Part A

If you require inpatient mental health care, Medicare Part A may help cover the following:

• Hospital stays for mental health conditions, including room and board, meals and necessary services

• Psychiatric hospital stays and services when the facility is distinct from a general hospital, with a limit of 190 days of inpatient care during a beneficiary’s lifetime

Medicare Part C (Medicare Advantage) and Mental Health Coverage

Medicare Advantage plans often offer additional mental health benefits beyond those covered by Part A and Part B that may include the following:

• Expanded therapy options and more extensive coverage for therapy and counseling

• Integrated mental health care with overall health care for managing conditions that affect both physical and psychological health

• Additional support services such as case management or wellness programs

Prescription Medications Under Medicare Part D

Mental health conditions often require medication management. Medicare Part D helps cover the cost of prescription drugs, which typically include antidepressants, antianxiety and antipsychotic medications.

Verify that your specific medications are covered under your Part D plan, as formularies can vary among providers.

Learn More

Contact Wimmer Insurance in Detroit Lakes, Minnesota, to learn more about how Medicare may help cover mental health services.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.